CTICasesIntrathoracic Stomach with Organoaxial Volvulus
Imaging findings
A coronal CT shows an intrathoracic stomach that is flipped upside down, with the greater curvature positioned along the top, indicative of an organoaxial volvulus. The transverse colon is also seen herniating into the chest. This patient experiences intermittent gastric outlet obstruction.
Key takeaways
Intrathoracic stomach, often due to a large hiatal hernia, can be complicated by organoaxial volvulus, where the stomach rotates along its long axis. This can lead to intermittent or acute gastric outlet obstruction and is considered a surgical emergency due to the risk of strangulation and ischemia. Recognizing the characteristic 'upside-down' stomach is key.
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